Objective:To investigate the influence of laparoscopic vagus nerve-preserving distal gastrectomy (VPG) on the postoperative quality of life (QOL) in patients with early stage distal gastric cancer.Methods: 142 patients with early-stage distal gastric cancer weredivided into VPG group (n=73) and conventional distal gastrectomy (CG) group (n=69). All the patients of the two groups underwent laparoscopic VPG and CG respectively. The perioperative indicators, survival and recurrence within 3 years after surgery were compared between the two groups. The Quality of Life Questionnare-Core 30(QLQ-C30) and Quality of Life Questionnare-Stomach Cancer 22(QLQ-STO22) were used to evaluate the QOL. Results: The anus exhaust time was significantly shorter in the VPG group than that in the CG group (P<0.05), but there was no significant difference in the number of lymph node dissection, operation time and intraoperative blood loss between the two groups (P>0.05). 3 months after surgery, fatigue, nausea and vomiting, appetite loss, constipation, diarrhea scores of QLQ-C30 and eating restriction, reflux, thirst, body image scores of QLQ-STO22 scale in the VPG group were significantly lower than those in the CG group (P<0.05); 12 months after surgery, appetite loss, diarrhea and body image scores in the VPG group were significantly lower than those in the CG group (P<0.05). The 1-year and 3-year survival rates, cumulative recurrence rate were 100%, 95.89% and 8.22% in the VPG group respectively, compared with 100.00%, 97.10% and 5.80% in the CG group, the difference was not statistically significant (P>0.05).Conclusion:Laparoscopic VPG is safe and effective in the treatment of early-stage distal gastric cancer, which can reduce the diarrhea, appetite loss, body shape change and improve the postoperative quality of life at 1 year after surgery. |
[1] 左婷婷,郑荣寿,曾红梅,等.中国胃癌流行病学现状[J].中国肿瘤临床,2017,44(1):52-58.
[2] 梁玉萍,刘维花,杨落落,等.早期胃癌的筛查[J].中华内科杂志,2014,53(4):325-326.
[3] 刘春阳,郝迎学.保留迷走神经胃癌根治术的研究现状与进展[J].中国普外基础与临床杂志,2016,23(11):1407-1412.
[4] 刘会侠,桂普国.腹腔镜下保留迷走神经的老年胃癌根治术52例分析[J].陕西医学杂志,2017,46(10):1388-1389.
[5] 万崇华,陈明清,张灿珍,等.癌症患者生命质量测定量表EORTC QLQ-C30中文版评介[J].实用肿瘤杂志,2005,20(4):353-355.
[6] 刘伟琳,杨舸,芮煜华,等. EORTC QLQ-STO22量表对我国胃癌患者有效性的验证[J].肿瘤研究与临床,2016,28(9):595-599.
[7] 梅勇,罗青,任江,等.早期远端胃癌行胃部分切除术中保留迷走神经的临床疗效分析[J].实用癌症杂志,2017,32(3):432-434.
[8] 李双喜,李子禹,张连海,等.腹腔镜下保留迷走神经及幽门胃切除术治疗早期胃癌的临床疗效[J].中华消化外科杂志,2017,16(3):298-303.
[9] 胡俊峰,邵钦树,孙元水,等.保留迷走神经、幽门胃部分切除手术在早期胃体癌中的应用[J].中华医学杂志,2015,95(14):1096-1099.
[10] 孙晓红,李卫东,付蔚华,等.胃癌患者术后生活质量的转变调查[J].山东医药,2014(29):73-75.
[11] 茹新力.保留胃迷走神经远端胃癌根治术对患者术后营养及生存情况的影响[J].浙江中西医结合杂志,2017,27(8):689-692.
[12] 廖南生,林峰.保留胃迷走神经远端胃癌根治术疗效及对患者术后营养状况和预后的影响[J].中华全科医学,2016,14(5):866-868.
[13] INOKUCHI M,OTSUKI S, KAWANO T,et al.Commentary on a randomized controlled trial of vagus nerve-preserving distal gastrectomy in early gastric cancer[J].Transl Cancer Res,2016,5(S3):S548-S550.
[14] LEE S S, CHUNG H Y, YU W. Quality of life of longterm survivors after a distal subtotal gastrectomy[J].Cancer Res Treat,2010, 42(3):130-134.
[15] KIM S M, CHO J, KANG D,et al.A randomized controlled trial of vagus nerve-preserving distal gastrectomy versus conventional distal gastrectomy for postoperative quality of life in early stage gastric cancer patients[J].Ann Surg,2016,263(6):1079-1084.
[16] 吴厚宾,谢小平,朱国民,等.保留迷走神经远端胃癌根治术患者的营养及预后[J].广东医学,2014,35(12):1923-1925.
[17] 黄师菊,周雪玲,李慧娟,等.胃癌患者围手术期营养状况对生活质量的影响调查[J].中华普通外科学文献(电子版),2013,7(5):400-403. |
